Health Skills 10-1
Skills of Effecive Weight Management Super Diet! Diet Power! So easy, they call it a miracle diet! Lose weight fast, effortlessly! Take off excess weight permanently...in your sleep! Hollywood stars reveal their diet secrets! These are but a few of the magazine headlines promising quick, easy, permanent weight loss. There are literally thousands of approaches to helping people lose weight, everything from low-carb, high-protein diets to diets named after trendy locales, such as the South Beach Diet. Think critically about diet ads and don’t be misled by outrageous claims (see the table below).
Weighing the Evidence in Diet Ads Flip through a magazine, scan a newspaper, or channel surf and you see them everywhere: ads that promise quick and easy weight loss without diet or exercise. Wouldn’t it be nice if—as the ads claim—you could lose weight simply by taking a pill, wearing a patch, or rubbing in a cream? Too bad claims like that are almost always false. Doctors, dieticians, and other experts agree that the best way to lose weight is to eat fewer calories and increase your physical activity so you burn more energy. A reasonable goal is to lose about one pound per week. For most people, that means cutting about 500 calories per day from your diet, eating a variety of nutritious foods, and exercising regularly. When it comes to evaluating claims for weight-loss products, the Federal Trade Commission (FTC) recommends a healthy portion of skepticism. Before you spend money on products that promise fast and easy results, weigh the claims carefully. Think twice before wasting your money on products that make any of these false claims: “Lose weight without diet or exercise!” Achieving a healthy weight takes work. Take a pass on any product that promises miraculous results without the effort. Buy one and the only thing you’ll lose is money. “Lose weight no matter how much you eat of your favorite foods!” Beware of any product that claims you can eat all you want of high-calorie foods and still lose weight. Losing weight requires sensible food choices. Filling up on healthy vegetables and fruits can make it easier to say no to fattening sweets and snacks. “Lose weight permanently! Never diet again!” Even if you’re successful in taking off the weight, permanent weight loss requires permanent
lifestyle changes. Don’t trust any product that promises once-and-for-all results without ongoing All Rights Reserved. © 2013 by Cengage Learning Inc. maintenance. “Block the absorption of fat, carbs, or calories!” Doctors, dieticians, and other experts agree that there’s simply no magic nonprescription pill that will allow you to block the absorption of fat, carbs, or calories. The key to curbing your craving for downfall foods is portion control. Limit yourself to a smaller serving or a slimmer slice. “Lose 30 pounds in 30 days!” Losing weight at the rate of one or two pounds per week is the most effective way to take it off and keep it off. At best, products promising lightning-fast weight loss are false. At worst, they can ruin your health. “Everybody will lose weight!” Your habits and health concerns are unique. There is simply no one-size-fits-all product guaranteed to work for everyone. Team up with your health care provider to design a personalized nutrition and exercise program suited to your lifestyle and metabolism.
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“Lose weight with our miracle diet patch or cream!” You’ve seen the ads for diet patches or creams that claim to melt away the pounds. Don’t believe them. There’s nothing you can wear or apply to your skin that will cause you to lose weight.
Source: Federal Trade Commission. (2004). Facts for consumers: Weighing the evidence in diet ads. Retrieved from http://www.ftc.gov/bcp/edu/pubs/consumer/health /hea03.shtm. Why Quickie Diets Don’t Work Quickie diets are no magic bullets for permanent weight control. In a nutshell, they fail to help people make lasting changes in eating and exercise habits. You may lose weight at first with a diet that places strict limits on calories or types of foods you can eat. But these diets are hard to follow and people quickly grow tired of the restricted food choices. They soon begin regaining any weight they lost. Despite promises of easy and lasting weight loss from many popular diets, the traditional advice remains the best: to lose weight effectively and keep it off, you need to reduce the number of calories consumed in your daily diet and increase your activity level. When it comes to weight-loss diets, it’s calories that count, not the particular type of diet you follow. The key factor to long-term success is sticking to a sensible calorie-cutting dietary plan. Leading health organizations, including the American Heart Association, specifically recommend against high-protein, low-carb diets such as the Atkins diet.1 The lack of nutritional balance and emphasis on high-fat sources of protein (that is, meat, eggs and cheese) in popular high-protein diet plans can lead to serious health problems, including cardiovascular disease. These diets simply rely too much on eating foods rich in fat and cholesterol. Some of these diets also limit important carbohydrates found in foods such as grains, fruits, and vegetables. Despite the popularity of high- protein, low-carb diets, there is still no conclusive evidence that they are both safe and effective in the long term.
What the Scientific Evidence Teaches about Popular Diets Scientists have begun putting popular diets to the test. In one research study, investigators found that while a high-protein, low-carb diet produced more immediate weight loss on average than a conventional low-calorie, low-fat diet, these differences washed out within the first year.2 Another recent study directly compared four popular diet plans: Weight Watchers (emphasis on cutting calories), Atkins (high in protein and fats, low in carbs), Zone (fairly high in protein, moderate carbs and fats), and Ornish (very low in fat, high in complex carbs).3 The results showed no significant differences in weight loss at the one-year mark between the four diets. Not surprisingly, people who followed their particular diet plan more closely tended to lose more weight. Dropout rates were also high across the board, but especially so for the Atkins and Ornish diets (50%). © 2013 by Cengage Learning Inc. All Rights Reserved. © 2013 by Cengage Learning Inc. Clearly, people are more successful with any diet or weight management program if they stick with it. Ultimately, successful weight management involves adoption of healthful diet and exercise habits that become part of the person’s lifestyle. Weight management is a lifelong challenge. The truth is not popular. It’s not what people seeking miracles want to hear, but it’s a message that resonates with millions of people who have succeeded in controlling their weight effectively. The following section is designed to help people who decide to undertake that challenge now.
How to Shed Extra Pounds and Keep Them Off
Set Realistic Goals Establish a reasonable, attainable weight goal for yourself. Use the BMI chart on page 206 as a guide, shooting for a BMI in the low 20s. Consider your body shape, family history, and age. Don’t expect to fit into your high school prom suit or dress at the age of 40.
Plan to Lose Weight Gradually Plan to lose weight gradually. Aim to lose from half a pound to about two pounds per week through cutting back on calories, eating nutritious foods, and increasing your activity level. It probably took continued Health Skills 10-1, continued
years to put on your excess weight. Allow yourself some time to take it off. The slower you take it off, the more likely you are to keep it off. Remember, gradually on, gradually off.
Access College, Community, and Online Resources Your college health or counseling service may provide health-related information you can use to develop a weight management plan that fits your needs. Many colleges and community organizations sponsor weight management programs, usually at little or modest cost. You may also help a friend in need gain access to weight management programs on campus or in your community. A wealth of weight management and nutritional information is also available online, through such resources as the Weight-Control Information Network sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases, which can be accessed at http://win .niddk.nih.gov/index.htm. Generally speaking, it’s also a good idea to talk things over with a health professional before making any substantial changes in your diet or exercise routine. You may have health concerns that should be taken into account when making these changes.
Plan a Diet You Can Live With To lose weight, you need to consume fewer calories than you burn to meet your body’s need for energy, increase your energy output, or both. Cutting calories is one way to tip the scale in your favor, but don’t sacrifice nutrition for the sake of calories. Nor should you megadose on vitamins and minerals to make up for skipping meals. Megadoses of supplements do not provide the nutritional components found naturally in foods and can be dangerous. Plan a weight management diet that meets your nutritional needs and cuts calories where you can best afford them. For example, cut down on sweets, cut back on snacks, and use fats and oils sparingly. One pound of body weight equals 3,500 calories, so you need to chop about 250 calories per day from your intake to lose half a pound per week. Cutting 500 calories per day can lead to an average weight loss of about one pound per week. Avoid crash diets. Don’t starve yourself. Make sensible choices that can become part of your regular lifestyle.
Shrink and Switch Eat smaller portions. Substitute low-calorie foods for high-calorie foods. If you regularly eat two six-ounce portions of meat per day, you can trim hundreds of calories per day by cutting back to two four-ounce portions. Substitute a four-ounce portion of skinless chicken or turkey for a portion of red meat. Drink tomato juice rather than a soft drink. © 2013 by Cengage Learning Inc. All Rights Reserved. © 2013 by Cengage Learning Inc. Change problem Eating Habits: The ABCs of Weight Management How you eat can be as important as what you eat. Use principles drawn from behavior modification to replace unhealthy eating habits with healthy ones. Behavior modification breaks down problem habits into the As, the Bs, and the Cs. The As are the antecedents (stimuli or cues) that trigger eating. These include external or environmental cues, such as the sight of other people eating in a cafeteria or the aromas emanating from your favorite bakery or your Aunt Sally’s kitchen. Emotional states, such as anger or boredom, are internal cues that can also trigger the urge to eat. Hunger itself is an internal cue for eating. People who shop before dinner, when they are hungry, are more likely to buy fattening foods than people who shop after dinner. The more you are subjected to cues for eating, the more likely you are to overeat. The Bs are the behaviors connected with eating. Behaviors such as taking large bites and swallowing without chewing thoroughly may not allow your brain the time it needs to feel satiated. You wind up eating more—much more!—than your body requires to be satisfied. The Cs are the consequences of eating and dieting. Food is a natural reinforcer. It provides immediate sensory pleasure (tastes good) and reduces feelings of hunger. These immediate rewards can outweigh the long-term problems connected with overeating, such as obesity and continued Health Skills 10-1, continued
related health risks. Behavior modification makes the immediate consequences of sensible eating more rewarding and the negative consequences of overeating more immediate. The table below lists various behavior modification techniques based on the ABCs of effective dieting. These techniques are best combined with a sensible calorie reduction and exercise program.4 Behavior modification focuses on changing problem eating behaviors to keep off lost weight. Behavior modification is not a panacea; it requires a serious commitment to making lasting changes in behaviors and lifestyles. Even with behavior modification, many people regain much, if not all, of the weight they lose within a few years. The problem is that many people eventually return to unhealthy eating and exercise patterns and begin putting the weight back on. The lesson here is that losing weight and keeping it off requires a lifelong commitment to a healthy diet and regular exercise program. How many of the ABCs listed in the following table can you use to make permanent changes in your eating habits? Behavioral Tips for Managing Your Weight Changing the As of Overeating Change the Environmental As • Avoid settings that trigger overeating (e.g., eat at The Celery Stalk, not at The Chocolate Gourmet). • Don’t leave tempting treats around the house. • Serve food on smaller plates. Use a lunch plate rather than a dinner plate. • Don’t encourage seconds by leaving serving dishes on the table. • Avoid the kitchen as much as possible. Chat on the phone or watch TV elsewhere. • Disconnect eating from other stimuli, such as watching TV, talking on the phone, and reading. • Establish food-free zones in your home. Place a mental barrier before the entrance to your bedroom: No food allowed! • Shop from a list. Don’t browse through the supermarket. • Shop quickly. Don’t make shopping the high point of your day. • Treat the supermarket like enemy territory. Avoid the aisles of junk food. If you must walk down them, wear mental blinders—fattening things come in pretty packages. • Never shop when hungry. Shop after a meal, not before. Change the Inner As All Rights Reserved. © 2013 by Cengage Learning Inc. • Don’t bury negative feelings in a box of cookies or a carton of mocha delight ice cream. • Relabel feelings of hunger as signals that you’re burning calories. Don’t let yourself get too hungry, however. Eat preplanned low-calorie snacks so you are not tempted to binge. Changing the Bs of Overeating Slow Down • Slow down your eating pace. • Put utensils down between bites. • Take smaller bites. • Chew thoroughly. • Savor each bite. Don’t wolf down bites to make room for the next. • Take a break during the meal. Converse with your family or guests. Give your blood sugar level a chance to rise and signal your brain. • When you resume eating, ask yourself whether you need to finish every bite. Leave something to be thrown away or enjoyed later.
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Do Something Other Than Eat • Substitute activities for unwanted snacking. When tempted to eat, leave the house, take a bath, walk the dog, call a friend, walk around the block. • Fill spare time with activities unrelated to food. Volunteer at a local hospital, play golf or tennis, join an exercise group, read in the library (not in the kitchen), take long walks. Changing the Cs of Overeating • Reward yourself for meeting calorie-intake goals. Since one pound of body weight is equivalent to 3,500 calories, to lose one pound per week, you need to cut 3,500 calories per week. Track what you eat and reward yourself for meeting weekly calorie goals with gifts you would not otherwise buy, such as a cashmere sweater or tickets to a show. Repeat the reward program from week to week. If during some weeks you miss your calorie goals, don’t lose heart. Get back on track the following week.
Track your Eating Habits Keep a food diary for a week or two to track what you eat and to identify problem eating habits. Each day, jot down in a diary everything you ate, where you ate it, your feeling state at the time (e.g., anxious, bored, angry, lonely, happy, or excited), and activity (e.g., watching TV, reading, talking on the phone, or having a meal). Tracking your eating habits is an example of self- monitoring, the process of observing and recording your behavior from day to day. Skills of self- monitoring are helpful in a wide range of other health-related issues, such as smoking, stress management, use of alcohol, and so on.
Identify Trouble Spots Examine your eating diary to identify trouble spots, such as situations associated with unplanned or excessive snacking. Do you gobble down hundreds of calories in afternoon snacks or while watching late-night TV? If so, plan other activities at these times. Exercise or plan a low-calorie snack.
Change Self-Defeating Ideas about Weight Control People who start one weight-loss diet after another tend to judge themselves harshly. They see themselves as good when they rigidly stick to their diets and bad when they stray, even a little. They see themselves as total failures for breaking a minor dieting rule, such as using a spoonful of sugar in their coffee if they run out of a sugar substitute. It’s an all-or-nothing type of thinking. Seeing themselves as failures may prompt them to binge (“What the heck. I’m off my diet, anyway.”). All Rights Reserved. © 2013 by Cengage Learning Inc. Changing irrational beliefs can be as important as changing problem behaviors. How do you change irrational beliefs? First, recognize them. Then, replace them with rational alternatives. Here are some adaptive thoughts you can substitute the next time you have a momentary lapse in eating healthier: • “Nobody’s perfect. Everyone overeats now and then. Now, let me get back to my regular diet.” • “It’s not the end of the world if I slip up. (Now, let me . . .)” • “I am not a good or bad person because of what I eat. I am a complete person, not just an eating machine. (Now, let me . . .)”
Break Connections between Eating and Emotions Do you use food to cope with negative emotions such as anxiety, depression, and anger? If so, find other ways to handle your feelings. Write about them in a diary. Talk them over with a friend. Discuss what’s on your mind with a counselor or a therapist. Don’t try to bury your emotions in chocolate cake.
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Develop a Regular Exercise Program . . . and Stick To It Combining a regular exercise program with a sensible calorie-reduction diet will help you lose weight more rapidly and keep off the weight you lose. Unfortunately, many people who start exercise programs drop out within a few months. To boost your odds of sticking with an exercise plan, select a gym that’s right for you—one that is conveniently located and fits your schedule. If possible, don’t go it alone. Ask a friend or your spouse to join you.
Counseling Professional counseling can help compulsive overeaters acquire a better understanding of the psychological problems that may underlie their problem eating habits. For example, a person who feels chronically unloved or unwanted may be using food as a substitute for love. Self-insight is not enough, however. To be successful, it must be coupled with behavioral changes.
Sources: 1American Heart Association. (2005). High-protein diets. Retrieved from http://216.185.112.5/presenter.jhtml. 2Foster, G. D., et al. (2003, May 22). A randomized trial of a low- carbohydrate diet for obesity. New England Journal of Medicine, 348, 2082–2090. Retrieved from http://www.nejm.org/doi/full/10.1056/NEJMoa022207#t=article. 3Dansinger, M. L., Gleason, J. A., Griffith, J. L., Selker, H. P., & Schaefer, E. J. (2005). Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: A randomized trial. Journal of the American Medical Association, 29(1), 43–53. Retrieved from http://jama.ama-assn.org/content/293/1/43.full. 4Jakicic, J. M., Marcus, B. H., Lang, W., & Janney, C. Effect of exercise on 24-month weight loss maintenance in overweight women. Archives of Internal Medicine, 168(14), 1550–1559. Retrieved from http://archinte .ama-assn.org/cgi/content/short/168/14/1550; Thompson, W. G., & Levine, J. A. (2008). Effect of exercise on 24-month weight loss maintenance in overweight women—Invited commentary. Archives of Internal Medicine, 168(14), 1559–1560. © 2013 by Cengage Learning Inc. All Rights Reserved. © 2013 by Cengage Learning Inc.